MEDICARE: VALIN HEWARD CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	10311804-3102	UT

General Provider Information

NPI Number	:	1679252720
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALIN HEWARD CRNA

Provider Business Mailing Address
First Line	:	11819 SW COVE RD
Second Line	:
City	:	VASHON
State	:	WA
Zip	:	98070-4007
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11819 SW COVE RD
Second Line	:
City	:	VASHON
State	:	WA
Zip	:	98070-4007
Country	:	US
Telephone Number	:	406-848-1941
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2023
Last Update Date	:	07/17/2023

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